Our long term goal is to develop novel mobile technologies to support self-management and care delivery for people with chronic conditions. One such population is individuals with Spina Bifida (SB), the most common permanently disabling birth defect in the US. Individuals with SB are vulnerable to secondary complications (e.g. urinary tract infections (UTIs), skin breakdowns) that can be prevented with self-care. We have initiated a Wellness Pilot Program in which Wellness Coordinators (WCs) supervised the care of individuals with SB, and results so far demonstrate remarkably improved outcomes in terms of reducing the number of medical complications and reducing healthcare costs. However, time and cost for travel limited our ability to scale up the program. One solution to reaching a larger cohort and improving access to care is to institute a mobile health service delivery system. The goal of this proposal is to develop novel mobile technologies - consisting of smartphone apps, a clinician portal, and a two-way communication connecting the two - to support self- management and service delivery for people with SB. The innovative system, called iMHere (iMobile Health and Rehabilitation), is designed to allow clinicians to monitor a patient's condition and send a treatment plan to a smartphone. The smartphone apps are designed to empower patients to do preventive self-care and will be adapted to user's disabilities. Clinicians will use the portal to tailor a treatment plan for each and every patient (e.g. suggesting a medication schedule, how to care for the wound, etc.) and the portal will push the plan to the smartphone apps. We will develop an advanced and efficient bi-directional data exchange between apps and the clinician portal. We will focus on the interactions between patients and clinicians in promoting self-adherence and self-care. We will conduct usability and accessibility studies of the smartphone apps and the portal, focusing on accessibility for patients with impairments commonly associated with SB, i.e., motor impairments. Twenty six patients will be involved design and accessibility/usability studies of the system. The innovative iMHere system will reduce the burden of care for providers, reduce the cost of supporting the wellness service and empower patients to conduct preventive self-care. These innovations will also improve the health outcomes of patients by reducing secondary complications such as infections and help to reduce the cost of care for people with chronic conditions, which accounts for three-quarters of the healthcare expenditure in the U.S. iMHere: A Novel mHealth for Enhanced Wellness